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Published in: BMC Health Services Research 1/2024

Open Access 01-12-2024 | Research

Supporting first-time parents in their homes: an informal setting enabling interprofessional collaboration

Authors: Cecilia Franzén, Eva-Lotta Nilsson

Published in: BMC Health Services Research | Issue 1/2024

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Abstract

Background

Home visiting programmes aiming to support parents and promote more equal health amongst young children have grown in Sweden and in other countries. These programmes involve interprofessional teams. Teamwork in interprofessional contexts often requires setting boundaries, but professionals’ boundary work in the home setting is unexplored. Therefore, this article focuses on interprofessional teams comprising child healthcare nurses, midwives, social workers, and dental hygienists in a home visiting programme for first-time parents in Sweden; it aims to explore how the professionals performed boundary work that enabled collaboration and to investigate important contextual conditions for this kind of boundary work.

Methods

The data were drawn from semi-structured interviews with twelve professionals from the four different disciplines. Content analysis was used to explore their boundary work.

Results

The findings show that the professionals performed three forms of collaborative boundary work. They maintained boundaries by clarifying their distinct roles and expertise. However, the differences were viewed as complementary, and the professionals worked together humbly to complement each other’s knowledge and perspectives. Lastly, they tended to drop perceptions of prestige and blurred the boundaries to accommodate their overlapping knowledge. Important conditions for the success of collaborative boundary work were meetings prior to the home visits, the opportunities for discussion and reflection after the home visits, and the informal character of the home setting. Consequently, the professionals were able to jointly contribute to a holistic view of the visited families, which increased the possibilities to meet these families’ needs.

Conclusions

This study contributes knowledge on boundary work in interprofessional collaborations in the home setting. The informal character of the home setting seemed to facilitate collaboration and contributed to creating informal professional roles. The findings suggest that having interprofessional teams in the home setting enabled collaboration as well as reinforced support for first-time parents, which emphasizes the merit of home visit programmes.
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Literature
1.
go back to reference Meier N. Collaboration in healthcare through boundary work and boundary objects. Qualitative Sociol Rev. 2015;11:60–82.CrossRef Meier N. Collaboration in healthcare through boundary work and boundary objects. Qualitative Sociol Rev. 2015;11:60–82.CrossRef
3.
go back to reference Apesoa-Varano EC. Interprofessional conflict and repair: a study of boundary work in the hospital. Sociol Perspect. 2013;56:327–49.CrossRef Apesoa-Varano EC. Interprofessional conflict and repair: a study of boundary work in the hospital. Sociol Perspect. 2013;56:327–49.CrossRef
4.
go back to reference Carmel S. Boundaries obscured and boundaries reinforced: incorporation as a strategy of occupational enhancement for intensive care. Sociol Health Ill. 2006;28:154–77.CrossRef Carmel S. Boundaries obscured and boundaries reinforced: incorporation as a strategy of occupational enhancement for intensive care. Sociol Health Ill. 2006;28:154–77.CrossRef
5.
go back to reference Hunter B, Segrott J. Renegotiating inter-professional boundaries in maternity care: implementing a clinical pathway for normal labour. Sociol Health Ill. 2014;36:719–37.CrossRef Hunter B, Segrott J. Renegotiating inter-professional boundaries in maternity care: implementing a clinical pathway for normal labour. Sociol Health Ill. 2014;36:719–37.CrossRef
6.
go back to reference Liberati AG, Gorli M, Scaratti G. Invisible walls within multidisciplinary teams: disciplinary boundaries and their effects on integrated care. Soc Sci Med. 2016;150:31–9.CrossRefPubMed Liberati AG, Gorli M, Scaratti G. Invisible walls within multidisciplinary teams: disciplinary boundaries and their effects on integrated care. Soc Sci Med. 2016;150:31–9.CrossRefPubMed
7.
go back to reference Powell AE, Davies HTO. The struggle to improve patient care in the face of professional boundaries. Soc Sci Med. 2012;75:808–14.CrossRef Powell AE, Davies HTO. The struggle to improve patient care in the face of professional boundaries. Soc Sci Med. 2012;75:808–14.CrossRef
8.
go back to reference Salhani D, Coulter I. The politics of interprofessional working and the struggle for professional autonomy in nursing. Soc Sci Med. 2009;68:1221–28.CrossRefPubMed Salhani D, Coulter I. The politics of interprofessional working and the struggle for professional autonomy in nursing. Soc Sci Med. 2009;68:1221–28.CrossRefPubMed
9.
go back to reference Barnes W, Bullock A, Chestnutt IG, Cowpe J, Moons K, Warren W. Dental therapists in general dental practice. A literature review and case-study analysis to determine what works, why, how and in what circumstances. Eur J Dent Educ. 2020;24:109–20.CrossRefPubMed Barnes W, Bullock A, Chestnutt IG, Cowpe J, Moons K, Warren W. Dental therapists in general dental practice. A literature review and case-study analysis to determine what works, why, how and in what circumstances. Eur J Dent Educ. 2020;24:109–20.CrossRefPubMed
10.
go back to reference Franzén C. Boundary work of dentists in everyday work. Community Dent Oral. 2012;40:377–84.CrossRef Franzén C. Boundary work of dentists in everyday work. Community Dent Oral. 2012;40:377–84.CrossRef
11.
go back to reference Franzén C. The complexities of boundaries, task claims and professional identity in teamwork: from dentists’ perspective. Professions Professionalism. 2020;10:e2698. Franzén C. The complexities of boundaries, task claims and professional identity in teamwork: from dentists’ perspective. Professions Professionalism. 2020;10:e2698.
12.
go back to reference Azzi-Lessing L. Home visitation programs: critical issues and future directions. Early Child Res Q. 2011;26:387–98.CrossRef Azzi-Lessing L. Home visitation programs: critical issues and future directions. Early Child Res Q. 2011;26:387–98.CrossRef
13.
go back to reference Finello KM, Terteryan A, Riewerts RJ. Home visiting programs: what the primary care clinician should know. Curr Prob Pediatr Ad. 2016;46:101–25. Finello KM, Terteryan A, Riewerts RJ. Home visiting programs: what the primary care clinician should know. Curr Prob Pediatr Ad. 2016;46:101–25.
14.
go back to reference Larsen A, Broberger E, Petersson P. Complex caring needs without simple solutions: the experience of interprofessional collaboration among staff caring for older people with multimorbidity at home care settings. Scand J Caring Sc. 2016;31:2. Larsen A, Broberger E, Petersson P. Complex caring needs without simple solutions: the experience of interprofessional collaboration among staff caring for older people with multimorbidity at home care settings. Scand J Caring Sc. 2016;31:2.
15.
go back to reference Vaartio-Rajalin H, Fagerström L. Professional care at home: Patient‐ centredness, interprofessionality and effectivity? A scoping review. Health Soc Care Comm. 2019;27:e270–88.CrossRef Vaartio-Rajalin H, Fagerström L. Professional care at home: Patient‐ centredness, interprofessionality and effectivity? A scoping review. Health Soc Care Comm. 2019;27:e270–88.CrossRef
16.
go back to reference Nievar MA, Van Egeren LA, Pollard S. A meat-analysis of home visiting programs: moderators of improvements in maternal behavior. Infant Ment Health J. 2010;31:499–520.CrossRefPubMed Nievar MA, Van Egeren LA, Pollard S. A meat-analysis of home visiting programs: moderators of improvements in maternal behavior. Infant Ment Health J. 2010;31:499–520.CrossRefPubMed
17.
go back to reference Burström B, Marttila A, Kulane A, Lindberg L, Burström K. Practising proportionate universalism: a study protocol of an extended postnatal home visiting programme in a disadvantaged area in Stockholm, Sweden. BMC Health Serv Res. 2017;17:91.CrossRefPubMedPubMedCentral Burström B, Marttila A, Kulane A, Lindberg L, Burström K. Practising proportionate universalism: a study protocol of an extended postnatal home visiting programme in a disadvantaged area in Stockholm, Sweden. BMC Health Serv Res. 2017;17:91.CrossRefPubMedPubMedCentral
19.
go back to reference Axelsson SB, Axelsson R. From territoriality to altruism in interprofessional collaboration and leadership. J Interprof Care. 2009;23:320–30.CrossRefPubMed Axelsson SB, Axelsson R. From territoriality to altruism in interprofessional collaboration and leadership. J Interprof Care. 2009;23:320–30.CrossRefPubMed
20.
go back to reference Williams A. Changing geographies of care: employing the concept of therapeutic landscapes as a framework in examining home space. Soc Sci Med. 2002;55:141–54.CrossRefPubMed Williams A. Changing geographies of care: employing the concept of therapeutic landscapes as a framework in examining home space. Soc Sci Med. 2002;55:141–54.CrossRefPubMed
21.
go back to reference Ferguson H. Making home visits: Creativity and the embodied practices of home visiting in social work and child protection. Qual Soc Work. 2018;17:65–80.CrossRefPubMed Ferguson H. Making home visits: Creativity and the embodied practices of home visiting in social work and child protection. Qual Soc Work. 2018;17:65–80.CrossRefPubMed
22.
go back to reference Hall C, Slembrouck S, Haigh E, Lee A. The management of professional roles during boundary work in child welfare. Int J Soc Welf. 2010;19:348–57.CrossRef Hall C, Slembrouck S, Haigh E, Lee A. The management of professional roles during boundary work in child welfare. Int J Soc Welf. 2010;19:348–57.CrossRef
23.
go back to reference Allen D. Doing occupational demarcation: the ‘boundary work’ of nurse managers in a district general hospital. J Contemp Ethnogr. 2000;29:326–56.CrossRef Allen D. Doing occupational demarcation: the ‘boundary work’ of nurse managers in a district general hospital. J Contemp Ethnogr. 2000;29:326–56.CrossRef
24.
go back to reference Mizrachi N, Shuval J, Gross S. Boundary at work: alternative medicine in biomedical settings. Sociol Health Ill. 2005;27:20–43.CrossRef Mizrachi N, Shuval J, Gross S. Boundary at work: alternative medicine in biomedical settings. Sociol Health Ill. 2005;27:20–43.CrossRef
25.
go back to reference Nancarrow SA, Borthwick AM. Dynamic professional boundaries in the healthcare workforce. Sociol Health Ill. 2005;27:897–919.CrossRef Nancarrow SA, Borthwick AM. Dynamic professional boundaries in the healthcare workforce. Sociol Health Ill. 2005;27:897–919.CrossRef
26.
go back to reference Risan M. Negotiating professional expertise: hybrid educators’ boundary work in the context of higher education-based teacher education. Teach Teach Educ. 2022;109:103559.CrossRef Risan M. Negotiating professional expertise: hybrid educators’ boundary work in the context of higher education-based teacher education. Teach Teach Educ. 2022;109:103559.CrossRef
27.
go back to reference Sanders T, Harrison S. Professional legitimacy claims in the multidisciplinary workplace: the case of heart failure care. Sociol Health Ill. 2008;30:298–308.CrossRef Sanders T, Harrison S. Professional legitimacy claims in the multidisciplinary workplace: the case of heart failure care. Sociol Health Ill. 2008;30:298–308.CrossRef
28.
go back to reference Langley A, Lindberg K, Mørk BE, Nicolini D, Raviola E, Walter L. Boundary work among groups, occupations, and organizations. From cartography to process. Acad Manag Ann. 2019;13:704–36.CrossRef Langley A, Lindberg K, Mørk BE, Nicolini D, Raviola E, Walter L. Boundary work among groups, occupations, and organizations. From cartography to process. Acad Manag Ann. 2019;13:704–36.CrossRef
29.
go back to reference Alvesson M. The triumph of emptiness: consumption, higher education, and work organization. Oxford: Oxford University Press; 2013.CrossRef Alvesson M. The triumph of emptiness: consumption, higher education, and work organization. Oxford: Oxford University Press; 2013.CrossRef
30.
go back to reference Comeau-Vallée M, Langley A. The interplay of inter- and intraprofessional boundary work in multidisciplinary teams. Organ Stud. 2020;41:1649–72.CrossRef Comeau-Vallée M, Langley A. The interplay of inter- and intraprofessional boundary work in multidisciplinary teams. Organ Stud. 2020;41:1649–72.CrossRef
31.
go back to reference National Board of Health and Welfare. Överenskommelserna Om ökad tillgänglighet i barnhälsovården. [Agreement of increased accessibility in child healthcare]. Stockholm: National Board of Health and Welfare. In Swedish; 2020. National Board of Health and Welfare. Överenskommelserna Om ökad tillgänglighet i barnhälsovården. [Agreement of increased accessibility in child healthcare]. Stockholm: National Board of Health and Welfare. In Swedish; 2020.
32.
go back to reference Hinton L, Ryan S, Interviews IC, Pope, Mays N (Red.), editors. Qualitative research in health care. Oxford: Wiley Blackwell; 2020. pp. 43–56. Hinton L, Ryan S, Interviews IC, Pope, Mays N (Red.), editors. Qualitative research in health care. Oxford: Wiley Blackwell; 2020. pp. 43–56.
33.
go back to reference Franzén C. Dental professionals participating in a home visiting programme for first-time parents. Community Dent Health. 2023;40(2):97–102.PubMed Franzén C. Dental professionals participating in a home visiting programme for first-time parents. Community Dent Health. 2023;40(2):97–102.PubMed
34.
go back to reference Elo S, Kyngäs H. The qualitative content analysis. J Ad Nurs. 2008;62:107–15.CrossRef Elo S, Kyngäs H. The qualitative content analysis. J Ad Nurs. 2008;62:107–15.CrossRef
35.
go back to reference Fournier V. Boundary work and the (un)making of the professions. In: Malin N, editor. Professionalism, boundaries and the workplace. London: Routledge; 2000. pp. 67–86. Fournier V. Boundary work and the (un)making of the professions. In: Malin N, editor. Professionalism, boundaries and the workplace. London: Routledge; 2000. pp. 67–86.
36.
go back to reference Schot E, Tummers L, Noordegraaf M. Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. J Interprof Care. 2020;34:332–42.CrossRefPubMed Schot E, Tummers L, Noordegraaf M. Working on working together. A systematic review on how healthcare professionals contribute to interprofessional collaboration. J Interprof Care. 2020;34:332–42.CrossRefPubMed
37.
go back to reference Brante T. The professional landscape: the historical development of professions in Sweden. Professions Professionalism. 2013;3. Brante T. The professional landscape: the historical development of professions in Sweden. Professions Professionalism. 2013;3.
38.
go back to reference Van Bochove M, Tonkens E, Verplanke L, Roggeveen S. Reconstructing the professional domain: boundary work of professionals and volunteers in the context of social service reform. Curr Sociol. 2018;66:392–411.CrossRef Van Bochove M, Tonkens E, Verplanke L, Roggeveen S. Reconstructing the professional domain: boundary work of professionals and volunteers in the context of social service reform. Curr Sociol. 2018;66:392–411.CrossRef
39.
go back to reference Allen D. The nursing-medical boundary: a negotiated order? Sociol Health Ill. 1997;19:498–520. Allen D. The nursing-medical boundary: a negotiated order? Sociol Health Ill. 1997;19:498–520.
40.
go back to reference Eriksson A, Bihari Axelsson S, Axelsson R. Collaboration in workplace health promotion: a case study. Int J Workplace Health Manage. 2012;5:181–92.CrossRef Eriksson A, Bihari Axelsson S, Axelsson R. Collaboration in workplace health promotion: a case study. Int J Workplace Health Manage. 2012;5:181–92.CrossRef
Metadata
Title
Supporting first-time parents in their homes: an informal setting enabling interprofessional collaboration
Authors
Cecilia Franzén
Eva-Lotta Nilsson
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2024
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-024-10949-6

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